HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

Suggest Treatment For High Allergy In Child

Posted on Thu, 4 Sep 2014

Question: My daughter has just turned two. We went to the pediatrician for follow up on recurring issues. The below problems are listed on the visit summary. These are concerns we have brought to the pediatrican over several visits that seem to be ongoing.

Acute and chronic dacryocytisis
Allergic rhinitis
Constipation
Diaper rash
Eczema

The pediatrician prescribed an immunocap and a cbc with diff.

The results came back as high allergy to raw egg, dust mites. Medium allergy to milk and low allergy to dog dander and peanut. We have an appt to see the allergist next Monday. The concerning blood work was the cbc with diff. I have posted a previous question to a very nice pediatrican noting that I have been concerned with the possibilty of some obscure infection affecting my daughter. I have had athritic lile symtoms while nothing runs in my family. I have an appt with a concierge doctor next week. Hopefull he will be the doctor we go with. However, he is internal medicine and does not see children. I am worried that we are not doung enough to ensure everything is ok with our daughter. The results from her CBC with diff are attached.

Thank you

Answered by Dr. Deepak Kishore Kaltari (1 hour later)

Brief Answer:
The lesion is Urticaria

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Dear Mr XXXXXXX

The CBC report of XXXXXXX is perfectly fine. The skin lesion appears to be Urticaria especially if the lesion are known for spontaneous resolution and keep changing the site and associated with itching and the lesion blanch on applying pressure. The lesion are unlikely to be infectious in origin or genetic in origin. Eczema is seen in children and is usually due to internal allergy to food or external allergen like dust and pollen. It is usually self limiting.
If there are lesion in between the finger spaces(web spaces) and are itchy then possibility of scabies also needs to be considered.

Assessment by Immunologist and Pediatric Surgeon will be required.

Coming to issue of constipation and diaper rash, it would be helpful if you could provide following additional information

1. What is the frequency of passing stools?
2. Does she strain /excessive crying while passing stool?
3. Are the stool hard and ball like?
4. Are there any urinary complaints?
5. Is the diaper rash severe?

Awaiting your response

Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCh
Consultant Pediatric Surgeon

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (9 minutes later)

The stool is frequently hard and ball like. She has milk allergies and she loves milk so we're cutting that back. She passes stool appx every other day, sometimes every couple days. Then its usually very hard and large. Have you seen similar atypical lymphocytes on a two year old? It appears to be related to viral and some bacterial infections. I mean no disrespect, but i requested a hematologist. It appears you are a pediatrician. Is there any way to have a hematologist look at the results are would they require additional testing? Do you recommend testing for epstein barr, cmv, taxoplasmosis, etc?

Thank yo

Answered by Dr. Deepak Kishore Kaltari (54 minutes later)

Brief Answer:
atypical lymphocytes could be occasionally seen

Detailed Answer:
Hi
Dear Mr XXXXXXX

Atypical Lymphocytes are non specific finding seen in many infection like Infectious Mononucleosis, Upper respiratory tract infection. I have discussed 6 this with my Pediatric Hematologist colleague too.
Was the mother tested for TORCH(Toxoplasmosis, Rubella, cmv and herpes ) during pregnancy? If the results are negative and there is no pet animal at home then there is no need for testing it specifically for it.
I would suggest you the following
1. Thorough clinical examination by Pediatrician to rule out any lymph node , spleen and liver enlargement
2. Atypical Lymphocytes are only significant if they exceed more than 10 percent of Total Leucocyte count. Occasional visualisation of Atypical Lymphocytes is quite common in children . As the total leucocyte count is within normal limit and there are no other abnormal cells seen there seems to be no cause for concern
3. Get A peripheral blood smear examination done

Majority of cause of constipation is due to following
1. Diet factors
2. Reduced intake of water
3. Local anal condition like anal fissure
4. Rare possibility of Hirschsprung disease

I would suggest you the following

1. Thorough examination from Pediatrician/Pediatric Surgeon
2. Ensure good intake of fluids : 1 small cup of water 1 hour before and 1 hour after every meals will ensure adequate intake of fluids.

Do keep me updated

Take care

Best regards
Dr Deepak

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Deepak Kishore Kaltari (8 minutes later)

Thank you Dr. XXXXXXX I will discuss the TORCH tests with my wife and follow up with the pediatrician. We do have a dog at home. I will keep you updated on the proceedings

XXXX

Answered by Dr. Deepak Kishore Kaltari (9 minutes later)

Brief Answer:
Take care

Detailed Answer:
Hi
Dear Bro

Wishing you and your family a very happy and healthy life.
Keep me updated

Regards
Deepak

Note: For further queries related to your child health, Talk to a Pediatrician. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar